Urinary Tract Infections (UTIs) in Children

John Mersch, MD, FAAP

Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Urinary tract infections are a fairly common problem in
childhood and may have either a benign course responding to simple antibiotic
therapy or be associated with significant disruption in either the anatomy or
function of a child's urinary system. This article will focus on UTIs affecting
children, with an emphasis on those less than 2 years of age. Because of their
more unique and complicated nature, neonatal (less than 28 days of age) UTIs
will not be addressed as a specific issue. The principles discussed below,
however, are applicable to that age group.

The urinary tract is commonly divided into two areas. The upper urinary tract
consists of the kidneys and the delicate tubular structure (ureter) that runs
from the kidney to the bladder. The lower tract includes the bladder and the
urethra (the tube from the bladder to the outside of the body).

Urinary tract infection (UTI) facts

Childhood urinary tract infections are fairly
common and are generally caused by bacteria. Routine antibiotic therapy is
successful in resolving these infections.

Recurrent UTIs in children may be
indicative of malformation or malfunction of the urinary tract.

Common
symptoms and signs of UTIs in children include pain and urgency with urination,
blood in the urine, abdominal/pelvic pain, fever, flank pain, and vomiting.

Some selected children who experience a UTI should have diagnostic studies
performed. These children include children less than 2 years of age, any male
child, any child who has had more than one UTI or any child who has had
pyelonephritis.

Several recommendations exist to help lessen the likelihood
of a child developing a UTI.

What causes urinary tract infections in children?

Bacteria cause the large majority of urinary tract infections in children.
Viral infection of the bladder is less common, while fungal infections of the
urinary tract are rare and occur most commonly in immunocompromised individuals
(for example, those with HIV/AIDS, chemotherapy recipients).